|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$1,674.94 |
| Rate for Payer: Aetna Commercial |
$1,581.89
|
| Rate for Payer: Aetna Medicare |
$483.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$581.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$581.58
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$465.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.97
|
| Rate for Payer: BCN Commercial |
$1,446.97
|
| Rate for Payer: BCN Medicare Advantage |
$465.26
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,600.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.26
|
| Rate for Payer: Healthscope Commercial |
$1,674.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.79
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.53
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$535.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: Nomi Health Commercial |
$1,526.06
|
| Rate for Payer: PACE Senior Care Partners |
$442.00
|
| Rate for Payer: PACE SWMI |
$465.26
|
| Rate for Payer: PHP Commercial |
$1,581.89
|
| Rate for Payer: PHP Medicare Advantage |
$465.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,619.11
|
| Rate for Payer: Priority Health Medicare |
$469.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.90
|
| Rate for Payer: Railroad Medicare Medicare |
$465.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,637.72
|
| Rate for Payer: UHC Core |
$1,553.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.26
|
| Rate for Payer: UHC Exchange |
$465.26
|
| Rate for Payer: UHC Medicare Advantage |
$465.26
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$465.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.79
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,209.68 |
| Max. Negotiated Rate |
$1,674.94 |
| Rate for Payer: Aetna Commercial |
$1,581.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,519.18
|
| Rate for Payer: BCN Commercial |
$1,438.22
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,600.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Healthscope Commercial |
$1,674.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: Nomi Health Commercial |
$1,526.06
|
| Rate for Payer: PHP Commercial |
$1,581.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,619.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,637.72
|
| Rate for Payer: UHC Core |
$1,553.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.79
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$630.95 |
| Max. Negotiated Rate |
$873.62 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: BCBS Trust/PPO |
$792.37
|
| Rate for Payer: BCN Commercial |
$750.15
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO |
$844.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.21
|
| Rate for Payer: UHC Core |
$810.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.02
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.54 |
| Max. Negotiated Rate |
$873.62 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna Medicare |
$252.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.34
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$242.67
|
| Rate for Payer: BCBS Trust/PPO |
$798.00
|
| Rate for Payer: BCN Commercial |
$754.71
|
| Rate for Payer: BCN Medicare Advantage |
$242.67
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.67
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.02
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.81
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE Senior Care Partners |
$230.54
|
| Rate for Payer: PACE SWMI |
$242.67
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: PHP Medicare Advantage |
$242.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO |
$844.50
|
| Rate for Payer: Priority Health Medicare |
$245.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.36
|
| Rate for Payer: Railroad Medicare Medicare |
$242.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.21
|
| Rate for Payer: UHC Core |
$810.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.67
|
| Rate for Payer: UHC Exchange |
$242.67
|
| Rate for Payer: UHC Medicare Advantage |
$242.67
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$242.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.02
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.76 |
| Max. Negotiated Rate |
$268.14 |
| Rate for Payer: Aetna Commercial |
$253.24
|
| Rate for Payer: Aetna Medicare |
$77.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.10
|
| Rate for Payer: BCBS Complete |
$184.65
|
| Rate for Payer: BCBS MAPPO |
$74.48
|
| Rate for Payer: BCBS Trust/PPO |
$244.93
|
| Rate for Payer: BCN Commercial |
$231.64
|
| Rate for Payer: BCN Medicare Advantage |
$74.48
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.48
|
| Rate for Payer: Healthscope Commercial |
$268.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.45
|
| Rate for Payer: Mclaren Medicaid |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.21
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: PACE Senior Care Partners |
$70.76
|
| Rate for Payer: PACE SWMI |
$74.48
|
| Rate for Payer: PHP Commercial |
$253.24
|
| Rate for Payer: PHP Medicare Advantage |
$74.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health HMO/PPO |
$259.20
|
| Rate for Payer: Priority Health Medicare |
$75.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.61
|
| Rate for Payer: Railroad Medicare Medicare |
$74.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.18
|
| Rate for Payer: UHC Core |
$248.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.48
|
| Rate for Payer: UHC Exchange |
$74.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.48
|
| Rate for Payer: UHCCP Medicaid |
$175.84
|
| Rate for Payer: VA VA |
$74.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.45
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.65 |
| Max. Negotiated Rate |
$268.14 |
| Rate for Payer: Aetna Commercial |
$253.24
|
| Rate for Payer: BCBS Trust/PPO |
$243.20
|
| Rate for Payer: BCN Commercial |
$230.24
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Healthscope Commercial |
$268.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: PHP Commercial |
$253.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health HMO/PPO |
$259.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.18
|
| Rate for Payer: UHC Core |
$248.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.45
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.05
|
| Rate for Payer: BCN Commercial |
$1,064.15
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.04 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$358.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.31
|
| Rate for Payer: BCBS Complete |
$386.62
|
| Rate for Payer: BCBS MAPPO |
$344.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.03
|
| Rate for Payer: BCN Commercial |
$1,070.62
|
| Rate for Payer: BCN Medicare Advantage |
$344.25
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.25
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Mclaren Medicaid |
$368.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.46
|
| Rate for Payer: Meridian Medicaid |
$386.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Senior Care Partners |
$327.04
|
| Rate for Payer: PACE SWMI |
$344.25
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$344.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Medicare |
$347.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: Railroad Medicare Medicare |
$344.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.25
|
| Rate for Payer: UHC Exchange |
$344.25
|
| Rate for Payer: UHC Medicare Advantage |
$344.25
|
| Rate for Payer: UHCCP Medicaid |
$368.19
|
| Rate for Payer: VA VA |
$344.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$664.44 |
| Max. Negotiated Rate |
$2,517.88 |
| Rate for Payer: Aetna Commercial |
$2,377.99
|
| Rate for Payer: Aetna Medicare |
$727.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$874.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$874.26
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$699.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,299.94
|
| Rate for Payer: BCN Commercial |
$2,175.17
|
| Rate for Payer: BCN Medicare Advantage |
$699.41
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$2,405.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.41
|
| Rate for Payer: Healthscope Commercial |
$2,517.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,098.23
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.38
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$804.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,377.99
|
| Rate for Payer: Nomi Health Commercial |
$2,294.06
|
| Rate for Payer: PACE Senior Care Partners |
$664.44
|
| Rate for Payer: PACE SWMI |
$699.41
|
| Rate for Payer: PHP Commercial |
$2,377.99
|
| Rate for Payer: PHP Medicare Advantage |
$699.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,433.95
|
| Rate for Payer: Priority Health Medicare |
$706.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,874.42
|
| Rate for Payer: Railroad Medicare Medicare |
$699.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,461.92
|
| Rate for Payer: UHC Core |
$2,336.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.41
|
| Rate for Payer: UHC Exchange |
$699.41
|
| Rate for Payer: UHC Medicare Advantage |
$699.41
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$699.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,098.23
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,818.47 |
| Max. Negotiated Rate |
$2,517.88 |
| Rate for Payer: Aetna Commercial |
$2,377.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,283.71
|
| Rate for Payer: BCN Commercial |
$2,162.02
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$2,405.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Healthscope Commercial |
$2,517.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,098.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,377.99
|
| Rate for Payer: Nomi Health Commercial |
$2,294.06
|
| Rate for Payer: PHP Commercial |
$2,377.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,433.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,874.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,461.92
|
| Rate for Payer: UHC Core |
$2,336.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,098.23
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$758.09 |
| Max. Negotiated Rate |
$1,049.66 |
| Rate for Payer: Aetna Commercial |
$991.35
|
| Rate for Payer: BCBS Trust/PPO |
$952.04
|
| Rate for Payer: BCN Commercial |
$901.31
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,003.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Healthscope Commercial |
$1,049.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$874.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: Nomi Health Commercial |
$956.36
|
| Rate for Payer: PHP Commercial |
$991.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: Priority Health HMO/PPO |
$1,014.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$781.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,026.34
|
| Rate for Payer: UHC Core |
$973.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$874.72
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$1,049.66 |
| Rate for Payer: Aetna Commercial |
$991.35
|
| Rate for Payer: Aetna Medicare |
$303.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$364.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$364.47
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$291.57
|
| Rate for Payer: BCBS Trust/PPO |
$958.81
|
| Rate for Payer: BCN Commercial |
$906.79
|
| Rate for Payer: BCN Medicare Advantage |
$291.57
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,003.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.57
|
| Rate for Payer: Healthscope Commercial |
$1,049.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$874.72
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.15
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$335.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: Nomi Health Commercial |
$956.36
|
| Rate for Payer: PACE Senior Care Partners |
$276.99
|
| Rate for Payer: PACE SWMI |
$291.57
|
| Rate for Payer: PHP Commercial |
$991.35
|
| Rate for Payer: PHP Medicare Advantage |
$291.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: Priority Health HMO/PPO |
$1,014.67
|
| Rate for Payer: Priority Health Medicare |
$294.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$781.41
|
| Rate for Payer: Railroad Medicare Medicare |
$291.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,026.34
|
| Rate for Payer: UHC Core |
$973.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.57
|
| Rate for Payer: UHC Exchange |
$291.57
|
| Rate for Payer: UHC Medicare Advantage |
$291.57
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$291.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$874.72
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$543.05 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$151.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.28
|
| Rate for Payer: BCBS Complete |
$543.05
|
| Rate for Payer: BCBS MAPPO |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$479.51
|
| Rate for Payer: BCN Commercial |
$453.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.82
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.82
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$517.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$543.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Senior Care Partners |
$138.53
|
| Rate for Payer: PACE SWMI |
$145.82
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Medicare |
$147.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: Railroad Medicare Medicare |
$145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.82
|
| Rate for Payer: UHC Exchange |
$145.82
|
| Rate for Payer: UHC Medicare Advantage |
$145.82
|
| Rate for Payer: UHCCP Medicaid |
$517.15
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$450.76
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,729.74 |
| Max. Negotiated Rate |
$2,395.03 |
| Rate for Payer: Aetna Commercial |
$2,261.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,172.29
|
| Rate for Payer: BCN Commercial |
$2,056.53
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$2,288.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Healthscope Commercial |
$2,395.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,995.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: Nomi Health Commercial |
$2,182.13
|
| Rate for Payer: PHP Commercial |
$2,261.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,315.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,782.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,341.80
|
| Rate for Payer: UHC Core |
$2,222.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,995.86
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
OP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$558.62 |
| Max. Negotiated Rate |
$2,395.03 |
| Rate for Payer: Aetna Commercial |
$2,261.97
|
| Rate for Payer: Aetna Medicare |
$691.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$831.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$831.61
|
| Rate for Payer: BCBS Complete |
$586.59
|
| Rate for Payer: BCBS MAPPO |
$665.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,187.72
|
| Rate for Payer: BCN Commercial |
$2,069.04
|
| Rate for Payer: BCN Medicare Advantage |
$665.28
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$2,288.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.28
|
| Rate for Payer: Healthscope Commercial |
$2,395.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,995.86
|
| Rate for Payer: Mclaren Medicaid |
$558.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.55
|
| Rate for Payer: Meridian Medicaid |
$586.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$765.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: Nomi Health Commercial |
$2,182.13
|
| Rate for Payer: PACE Senior Care Partners |
$632.02
|
| Rate for Payer: PACE SWMI |
$665.28
|
| Rate for Payer: PHP Commercial |
$2,261.97
|
| Rate for Payer: PHP Medicare Advantage |
$665.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,315.19
|
| Rate for Payer: Priority Health Medicare |
$671.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,782.96
|
| Rate for Payer: Railroad Medicare Medicare |
$665.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,341.80
|
| Rate for Payer: UHC Core |
$2,222.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.28
|
| Rate for Payer: UHC Exchange |
$665.28
|
| Rate for Payer: UHC Medicare Advantage |
$665.28
|
| Rate for Payer: UHCCP Medicaid |
$558.62
|
| Rate for Payer: VA VA |
$665.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,995.86
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
IP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$107.09 |
| Max. Negotiated Rate |
$148.28 |
| Rate for Payer: Aetna Commercial |
$140.04
|
| Rate for Payer: BCBS Trust/PPO |
$134.49
|
| Rate for Payer: BCN Commercial |
$127.32
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$141.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Healthscope Commercial |
$148.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: Nomi Health Commercial |
$135.09
|
| Rate for Payer: PHP Commercial |
$140.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: Priority Health HMO/PPO |
$143.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.98
|
| Rate for Payer: UHC Core |
$137.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.56
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
OP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$39.13 |
| Max. Negotiated Rate |
$148.28 |
| Rate for Payer: Aetna Commercial |
$140.04
|
| Rate for Payer: Aetna Medicare |
$42.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.48
|
| Rate for Payer: BCBS Complete |
$65.90
|
| Rate for Payer: BCBS MAPPO |
$41.19
|
| Rate for Payer: BCBS Trust/PPO |
$135.44
|
| Rate for Payer: BCN Commercial |
$128.09
|
| Rate for Payer: BCN Medicare Advantage |
$41.19
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$141.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.19
|
| Rate for Payer: Healthscope Commercial |
$148.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: Nomi Health Commercial |
$135.09
|
| Rate for Payer: PACE Senior Care Partners |
$39.13
|
| Rate for Payer: PACE SWMI |
$41.19
|
| Rate for Payer: PHP Commercial |
$140.04
|
| Rate for Payer: PHP Medicare Advantage |
$41.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: Priority Health HMO/PPO |
$143.33
|
| Rate for Payer: Priority Health Medicare |
$41.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.38
|
| Rate for Payer: Railroad Medicare Medicare |
$41.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.98
|
| Rate for Payer: UHC Core |
$137.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.19
|
| Rate for Payer: UHC Exchange |
$41.19
|
| Rate for Payer: UHC Medicare Advantage |
$41.19
|
| Rate for Payer: VA VA |
$41.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.56
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
OP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$877.71 |
| Max. Negotiated Rate |
$3,377.92 |
| Rate for Payer: Aetna Commercial |
$3,190.25
|
| Rate for Payer: Aetna Medicare |
$975.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,172.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,172.89
|
| Rate for Payer: BCBS Complete |
$921.66
|
| Rate for Payer: BCBS MAPPO |
$938.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,085.54
|
| Rate for Payer: BCN Commercial |
$2,918.14
|
| Rate for Payer: BCN Medicare Advantage |
$938.31
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$3,227.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.31
|
| Rate for Payer: Healthscope Commercial |
$3,377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.93
|
| Rate for Payer: Mclaren Medicaid |
$877.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.23
|
| Rate for Payer: Meridian Medicaid |
$921.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,079.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: Nomi Health Commercial |
$3,077.66
|
| Rate for Payer: PACE Senior Care Partners |
$891.39
|
| Rate for Payer: PACE SWMI |
$938.31
|
| Rate for Payer: PHP Commercial |
$3,190.25
|
| Rate for Payer: PHP Medicare Advantage |
$938.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: Priority Health HMO/PPO |
$3,265.32
|
| Rate for Payer: Priority Health Medicare |
$947.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,514.67
|
| Rate for Payer: Railroad Medicare Medicare |
$938.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,302.85
|
| Rate for Payer: UHC Core |
$3,133.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.31
|
| Rate for Payer: UHC Exchange |
$938.31
|
| Rate for Payer: UHC Medicare Advantage |
$938.31
|
| Rate for Payer: UHCCP Medicaid |
$877.71
|
| Rate for Payer: VA VA |
$938.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.93
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
IP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,439.61 |
| Max. Negotiated Rate |
$3,377.92 |
| Rate for Payer: Aetna Commercial |
$3,190.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,063.77
|
| Rate for Payer: BCN Commercial |
$2,900.50
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$3,227.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Healthscope Commercial |
$3,377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: Nomi Health Commercial |
$3,077.66
|
| Rate for Payer: PHP Commercial |
$3,190.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: Priority Health HMO/PPO |
$3,265.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,514.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,302.85
|
| Rate for Payer: UHC Core |
$3,133.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.93
|
|
|
HC INDWELLING PORT
|
Facility
|
IP
|
$1,361.50
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$884.98 |
| Max. Negotiated Rate |
$1,225.35 |
| Rate for Payer: Aetna Commercial |
$1,157.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.39
|
| Rate for Payer: BCN Commercial |
$1,052.17
|
| Rate for Payer: Cash Price |
$1,089.20
|
| Rate for Payer: Cofinity Commercial |
$1,170.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.20
|
| Rate for Payer: Healthscope Commercial |
$1,225.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,021.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.28
|
| Rate for Payer: Nomi Health Commercial |
$1,116.43
|
| Rate for Payer: PHP Commercial |
$1,157.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,184.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$912.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.12
|
| Rate for Payer: UHC Core |
$1,136.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,021.12
|
|
|
HC INDWELLING PORT
|
Facility
|
OP
|
$1,361.50
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$323.36 |
| Max. Negotiated Rate |
$1,225.35 |
| Rate for Payer: Aetna Commercial |
$1,157.28
|
| Rate for Payer: Aetna Medicare |
$353.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$425.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$425.47
|
| Rate for Payer: BCBS Complete |
$544.60
|
| Rate for Payer: BCBS MAPPO |
$340.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,119.29
|
| Rate for Payer: BCN Commercial |
$1,058.57
|
| Rate for Payer: BCN Medicare Advantage |
$340.38
|
| Rate for Payer: Cash Price |
$1,089.20
|
| Rate for Payer: Cofinity Commercial |
$1,170.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.38
|
| Rate for Payer: Healthscope Commercial |
$1,225.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,021.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.28
|
| Rate for Payer: Nomi Health Commercial |
$1,116.43
|
| Rate for Payer: PACE Senior Care Partners |
$323.36
|
| Rate for Payer: PACE SWMI |
$340.38
|
| Rate for Payer: PHP Commercial |
$1,157.28
|
| Rate for Payer: PHP Medicare Advantage |
$340.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,184.51
|
| Rate for Payer: Priority Health Medicare |
$343.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$912.21
|
| Rate for Payer: Railroad Medicare Medicare |
$340.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.12
|
| Rate for Payer: UHC Core |
$1,136.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.38
|
| Rate for Payer: UHC Exchange |
$340.38
|
| Rate for Payer: UHC Medicare Advantage |
$340.38
|
| Rate for Payer: VA VA |
$340.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,021.12
|
|
|
HC INFANT COOLING SYSTEM
|
Facility
|
IP
|
$670.91
|
|
| Hospital Charge Code |
27000644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$436.09 |
| Max. Negotiated Rate |
$603.82 |
| Rate for Payer: Aetna Commercial |
$570.27
|
| Rate for Payer: BCBS Trust/PPO |
$547.66
|
| Rate for Payer: BCN Commercial |
$518.48
|
| Rate for Payer: Cash Price |
$536.73
|
| Rate for Payer: Cofinity Commercial |
$576.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.73
|
| Rate for Payer: Healthscope Commercial |
$603.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.27
|
| Rate for Payer: Nomi Health Commercial |
$550.15
|
| Rate for Payer: PHP Commercial |
$570.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.09
|
| Rate for Payer: Priority Health HMO/PPO |
$583.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.40
|
| Rate for Payer: UHC Core |
$560.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.18
|
|
|
HC INFANT COOLING SYSTEM
|
Facility
|
OP
|
$670.91
|
|
| Hospital Charge Code |
27000644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$159.34 |
| Max. Negotiated Rate |
$603.82 |
| Rate for Payer: Aetna Commercial |
$570.27
|
| Rate for Payer: Aetna Medicare |
$174.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.66
|
| Rate for Payer: BCBS Complete |
$268.36
|
| Rate for Payer: BCBS MAPPO |
$167.73
|
| Rate for Payer: BCBS Trust/PPO |
$551.56
|
| Rate for Payer: BCN Commercial |
$521.63
|
| Rate for Payer: BCN Medicare Advantage |
$167.73
|
| Rate for Payer: Cash Price |
$536.73
|
| Rate for Payer: Cofinity Commercial |
$576.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.73
|
| Rate for Payer: Healthscope Commercial |
$603.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.27
|
| Rate for Payer: Nomi Health Commercial |
$550.15
|
| Rate for Payer: PACE Senior Care Partners |
$159.34
|
| Rate for Payer: PACE SWMI |
$167.73
|
| Rate for Payer: PHP Commercial |
$570.27
|
| Rate for Payer: PHP Medicare Advantage |
$167.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.09
|
| Rate for Payer: Priority Health HMO/PPO |
$583.69
|
| Rate for Payer: Priority Health Medicare |
$169.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.51
|
| Rate for Payer: Railroad Medicare Medicare |
$167.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.40
|
| Rate for Payer: UHC Core |
$560.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.73
|
| Rate for Payer: UHC Exchange |
$167.73
|
| Rate for Payer: UHC Medicare Advantage |
$167.73
|
| Rate for Payer: VA VA |
$167.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.18
|
|
|
HC INFECT AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
30000171
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$72.73
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$121.34
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$69.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$72.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.56
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.02
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$69.26
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
